Research over the last 20 years has proven that neurological emergencies once felt to be untreatable are, in fact, responsive to intervention. In particular, stroke and anoxic brain injury have been shown to be amenable to treatment. But, for all the exciting developments in emergency neurology, much remains to be done. Basic questions in emergency neurological disease remain unresolved and effective therapy is not always available to those who might benefit. This application describes a powerful tool for performing emergency neurological research. Our specific aims in setting up our Southeast Texas hub and spokes are: 1.To develop and expand our regional network of hospitals to efficiently conduct clinical trials of any neurological emergency. 2. To continue to enroll patiens at or above expected numbers for each trial and to follow all patients to study completion. 3. To maintain our small team of investigators to evaluate prospective trial participants, obtain consent and begin the trial. 4. To expand agreements which would allow our hub access to the electronic medical records of all patients enrolled in NETT studies by our spokes. This would enable us to better advice and monitor our remote spokes. 5. To increase participation by junior NETT investigators allowing them to assume leadership in hub management and spoke relations PUBLIC HEALTH RELEVANCE: Neurological Emergencies are common, affect all age groups and are particularly costly. Stroke, major head injuries and spinal cord injuries are major causes of death and disability. This research seeks to improve the outcomes of patients suffering from these devastating conditions.